My male cat weighs 17¼ pounds. We live in Florida, and approximately two months ago I noticed that my cat had begun to wheeze. When the wheezing worsened, I took him to a vet. The vet took his temperature, said it was normal, and listened to my cat’s heart and lungs, which he also said were normal. (The cat is wheezing and he heard nothing?) The vet gave us oral antibiotics, but I’m not sure what his reasoning was.
The cat was still wheezing and getting worse after a week. I took him to another vet and he took an X-ray and discovered he has asthma. That vet gave him a shot of cortisone. Two weeks later the cat is still wheezing, only not as bad; it has definitely improved, but has not gone away completely. Then I noticed that he sounded like he was having problems breathing through his nose. Could he have a sinus infection or allergy? I went back to the vet and this time he gave him a shot of an antibiotic to clear up the sinus infection, assuming that’s what he had. Over a week later, the cat is still having problems breathing through his nose.
What could possibly cause this nasal congestion and why hasn’t it gotten better?
Wheezing is the sound of air flowing through narrowed passageways. Often, cats wheeze because of some type of bronchitis, the most common types being infectious or allergic (asthma). Usually you will hear harsh lung sounds when you listen to the lungs with a stethoscope, however, wheezing can be intermittent, and sometimes a cat with a history of wheezing will have normal sounding lungs on physical examination. Regardless, a cat with a history of wheezing should have X-rays performed.
X-rays often reveal that the cat has some type of bronchitis, but it can be difficult to say whether it is allergic vs. infectious. A complete blood count can sometimes help. If elevated numbers of eosinophils (a type of white blood cell that is often associated with allergic or parasitic diseases) exist, vets leans toward a diagnosis of asthma. A high number of neutrophils (a type of white blood cell that is often associated with infectious disorders) suggests an infectious disorder. In many cases, the complete blood count is normal and does not provide any additional information. A vet achieves a definitive diagnosis with bronchoscopy or a transtracheal wash – a procedure in which sterile fluid is squirted into the lungs, retrieved and analyzed. These more invasive, expensive procedures are often not warranted in a simple, first-time presentation for coughing or wheezing.
A reasonable approach, which your vet has taken, is to assume that this might be an infectious thing and treat with a good broad-spectrum antibiotics for two or three weeks, and see if the cat responds. If there’s no improvement, you can try anti-inflammatory medications on the assumption that the cat is asthmatic. I personally do not like to give cortisone injections, especially in an overweight cat, for fear of inducing diabetes; oral steroids, in tapering doses, is a better way to go.
The fact that your cat showed a partial response to steroids suggests that he is asthmatic. Steroids, however, suppress the immune system, and your cat possibly developed an upper respiratory infection as a result of the steroid injection. This is one reason why I prefer oral steroids; if a negative side effect develops, you can discontinue the oral steroids and they’re out of the cat’s system in a day or two. A steroid injection can last for weeks, and once it’s injected, you can’t take it back.
Your cat being 17¼ pounds is certainly not helping. You need to put your cat on a diet. Overweight cats are more likely to have respiratory issues. Consult your vet for advice on the proper diet. You could use a prescription low-fat/high-fiber diet.
Once your cat’s upper respiratory infection resolves, a vet should administered steroids to your cat for asthma at higher doses for a few days, and then tapered the doses to the lowest dose that controls the wheezing. Medication, administered every other day, controls asthma in most cats. You might need a bronchodilator (a drug that helps open the air passages) in addition to the steroids, to keep your cat comfortable.